Cardiac Department, Freeman Hospital, Newcastle Upon Tyne, UK.
J Interv Cardiol. 2011 Oct;24(5):383-8. doi: 10.1111/j.1540-8183.2011.00658.x. Epub 2011 May 17.
Although the transradial approach is well established for percutaneous coronary intervention (PCI), it is perceived as being not suitable for 7-Fr complex PCI, which is traditionally performed from the femoral approach.
To evaluate the procedural success and outcome of 7-Fr transradial complex PCI.
Retrospective review and analysis of all patients undergoing 7-Fr transradial complex PCI from August 2008 until October 2010 in a tertiary cardiac center setting.
Transradial 7-Fr complex PCI was performed in 77 patients after manual assessment of the radial pulse and size. The radial access was obtained successfully in all 77 patients. The age range was 39-88 years with 16 patients (23.4%) over 80 years of age and 14 females (18.1%). There were 30 left main stem PCI (39%), 31 (40.2%) chronic total occlusion (CTO), and 13 (16.8%) rotational atherectomy. Intravascular ultrasound (IVUS) was used in 17 (22%) cases, cutting balloons in 16 (20.7%), and LASER PCI in 2 (2.6%) cases. Procedural success was achieved in 76 of 77 (98.7%) with 1 failure to canalize a CTO. There was 1 patient with type I coronary perforation managed conservatively. There was no in-hospital mortality. All radial pulses were present 6 hours after the procedure and only 23 patients were seen for follow-up, and all had patent radial artery 4-6 months following the procedure.
A 7-Fr transradial complex PCI is feasible and can be carried out safely and successfully with excellent results. In suitable patients, male or female, complex PCI need not always be performed from the femoral approach.
虽然经桡动脉入路在经皮冠状动脉介入治疗（PCI）中已得到广泛应用，但对于传统上经股动脉入路进行的 7Fr 复杂 PCI，人们认为该入路并不适用。
评估 7Fr 经桡动脉复杂 PCI 的手术成功率和结果。
回顾性分析 2008 年 8 月至 2010 年 10 月在一家三级心脏中心接受 7Fr 经桡动脉复杂 PCI 的所有患者。
在对桡动脉脉搏和大小进行手动评估后，77 例患者接受了 7Fr 经桡动脉复杂 PCI。77 例患者均成功获得桡动脉入路。年龄范围为 39-88 岁，其中 16 例（23.4%）年龄超过 80 岁，14 例为女性（18.1%）。30 例为左主干 PCI（39%），31 例（40.2%）为慢性完全闭塞（CTO），13 例（16.8%）为旋磨术。17 例（22%）患者使用了血管内超声（IVUS），16 例（20.7%）使用了切割球囊，2 例（2.6%）使用了 LASER PCI。77 例患者中，76 例（98.7%）手术成功，1 例 CTO 未能开通。1 例患者出现 I 型冠状动脉穿孔，经保守治疗后好转。住院期间无死亡病例。术后 6 小时所有桡动脉脉搏均存在，仅 23 例患者接受随访，所有患者术后 4-6 个月桡动脉均通畅。
7Fr 经桡动脉复杂 PCI 是可行的，可安全、成功地进行，且结果优异。对于合适的患者，无论男女，复杂 PCI 不一定非要经股动脉入路进行。
